About to have biopsy at 43yo with PSA of 5.2

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Regular Member

Date Joined Dec 2010
Total Posts : 35
   Posted 1/19/2011 1:33 PM (GMT -6)   
Hi All -

I've been following the discussions here off and on for the past couple of months since my first PSA spike in December. I can only handle little bits at a time before the anxiety gets too high. I keep catching myself scanning here and elsewhere online, looking to find the page that says "YOU do NOT have prostate cancer." Haven't found it yet.

Tomorrow is my biopsy and then I start The Wait for results. It sure would make me feel better if someone could look at my stats and tell me if I have cancer or not. (kidding, kidding).

Seriously, though, can anyone throw me a rope by telling of someone with PSA numbers like mine, no pain (as in prostatitis) who did not have cancer? I'm not seeing what else it could be, and my profile sure looks like a lot of the signatures I see here.

43 years old - four kids ages 2 to 10
Maternal grandfather with BPH starting in early fifties - no other prostate family history.

2008-03 - 2.6 - Just over the limit for a 40yo.
2008-06 - 3.4 - Uh oh. Off to the urologist.
2008-07 - 2.5 - Different lab. Urologist calms me down and talks me out of a biopsy.
2009-11 - 2.9 - A little higher but still in that high-two range.
2010-12 - 6.4 - ***!? Total freak-out. I demand a repeat just one week later.
2010-12 - 4.7 - A week later . . . that's better than 6.4. We hope it's "trending down" and wait 30 days
2011-01 - 5.2 - Sh*#. That's not trending down. Urologist orders a biopsy.

I was on Cipro for three weeks before that final test. No symptoms except a stream that is sometimes reluctant to start. That seems to have improved some. I'm on meds for blood pressure, cholesterol, and two different antidepressants (which we have been messing with since that 6.4).

Any advice for a scared newbie would be appreciated.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 1/19/2011 1:57 PM (GMT -6)   
Welcome to HW, sorry you have to join us. Hopefully, you can leave and never think of us again. There's no definite way (as you know) short of a biopsy to diagnois prostate cancer. From your info, there's nothing that would indicate either a yes or no, so you will have to wait for the results. Sorry I can't offer you anything else, but you're just gonna have to wait it out. You have found a good place to wait, and hopefully, we can tell you to leave and never come back shortly tongue
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 01/11-.09
ED-total-Bimix 30cc

Regular Member

Date Joined Aug 2008
Total Posts : 328
   Posted 1/19/2011 2:00 PM (GMT -6)   
Your best bet is to have the biopsy to give you some peace of mind. My only suggestion ONLY based on my own experience is demand them give you something before the procedure. And drink ALOT of water afterwards it helps with the side effects after words. Good Luck and Keep us informed. And hopefully as James says you just need to post all clear and never come back :)
Age Dx 37, 7/2008, First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008, Biopsy: 6 out 12 Postive all on right side, Gleason 7 (3+4).
Bone Scan/CAT Scan: Clear 7/2008
Da Vinci Surgery 7/2008, PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
7 Post Op PSA’s from 9/2008 to 11/2020: <0.1

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 1/19/2011 2:48 PM (GMT -6)   
You know there is no definitive answer from us.
If it will help, note that GENERALLY PC presents as a consistent rise over time (PSA).
Yours has been up and down. So, decent chance that it is prostatitis.
Hope that helps.

Regular Member

Date Joined Dec 2010
Total Posts : 35
   Posted 1/19/2011 2:56 PM (GMT -6)   
Okay, so compiler says I don't have PC! Thanks!

Seriously, I do appreciate the perspective, and you know I must be eager to know for sure if I'm actually LOOKING FORWARD to the biopsy . . .

Veteran Member

Date Joined Nov 2009
Total Posts : 7187
   Posted 1/19/2011 2:58 PM (GMT -6)   
LOL. Hear what you want to hear.
My bill is $400 for my EXPERT advice.
I accept PayPal

New Member

Date Joined Dec 2010
Total Posts : 6
   Posted 1/19/2011 3:46 PM (GMT -6)   
MoreData - look at my profile.  I am currnelty 49.  I have had 2 biopsies and 1 MRI between Jan 2010 and Dec 2010.  So far, so good.  I believe that at some point down the road, something will eventually be found.  In the meantime, however, I am not worrying about it until I have to.  I did enough worrying about this last one figuring for sure they were going to find something, particularly in light of the "suspicious" area on the MRI.
The biopsy is the only way you will know.  I understand the anxiety and, if there is a positive result, it seems like it would be found early and you research whatever option to get rid of it is best for you.  That is what my mindset finally was (in between the angst and worry, of course cool ).  My uro and I are going to watch this closely and take care of whatever eventually comes (if anything).
Good luck.
Mid-2008 PSA 2.4
Nov 2009 PSA 3.9, DRE fine, slightly enlarged
Jan 2010 Biopsy – 12 samples all negative
May 2010 PSA 4.1, DRE again OK
Nov 2010 PSA 4.5, DRE OK - MRI ordered
Dec 2010 MRI – revealed “suspicious” spot
12/22/10 Biopsy – 12 samples from suspicious area
1/5/11       Biopsy negative. Slight enlargement.  PSA is 4 mos.

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 1/19/2011 4:02 PM (GMT -6)   
Welcome...glad to see that you are keeping your sense of humor through an anxious period of time...

Two things that I would add to Dr Mel's earlier comment (be careful, he's an ambulance chaser):

(i) You should be aware that it is possible to have both prostate cancer (PC) and prostatitis, each of which would contribute abnormal amounts of PSA into your bloodstream simultaneously...in that case, it is impossible to tell how much PSA contribution comes from each source. Reiterating what Mel said, PSA from PC doesn't bounce up and down (except perhaps small amounts of measurement variation), but PSA from infection can go up and down without really knowing why.

(ii) Some prostatitis can be challenging to resolve, and a single dose of Cipro may not cure it. Some docs move on to another antibiotic (or two) before infection gets cured.

best wishes...

Post Edited (Casey59) : 1/19/2011 3:06:01 PM (GMT-7)

Regular Member

Date Joined Dec 2010
Total Posts : 99
   Posted 1/19/2011 7:48 PM (GMT -6)   


Welcome to HW, I am sorry you have to be here. I too hope you get good news and no longer have a need to be here. Prostate Cancer is a “strange bird”, no blood test can tell you that you have it; the only sure way to find out is the biopsy. Good luck and I will be praying for you.


Age 53...51 when diagnosed.
February/09 PSA 11...GP discoverd during yearly physical...referred to Urologist
Biopsy found cancer, Gleason score of 6.
July 2009...Nerve-Sparing open radical prostatectomy.
Doing very well...only issue is ED and that is getting better.

Veteran Member

Date Joined Sep 2008
Total Posts : 744
   Posted 1/19/2011 9:03 PM (GMT -6)   
Have you had a freePSA test done?

anxiety out the roof
Regular Member

Date Joined Aug 2010
Total Posts : 111
   Posted 1/20/2011 1:27 AM (GMT -6)   
If it is something- be glad to catch it early. I'm speaking from experience. I went through all the feeling you have [ look at my name]- we here all have. I'm 2 weeks out of surgery. I got a good report because things were caught early. My life is getting back to normal.
You have a wife and 2 children. Remember the prime directive is too survive to enjoy all 3 of them- and sooner or later you will

Regular Member

Date Joined Oct 2010
Total Posts : 175
   Posted 1/20/2011 6:36 AM (GMT -6)   
Moredata, here's my .02.

It is a far better thing to know you have PC and a plan to treat it, than to not know you have it and succumb to it.

about a week after my diagnosis and I started to feel sorry for myself, my local newspaper has a photo on the front page of a seven year old girl fighting a terminal leukemia. She had the biggest smile I've ever seen. Who the hell am I to feel sorry for myself when this poor child can be happy thru all her troubles.

You've got young kids and not only do you have to be strong for yourself, more importantly, you have to be strong for them.
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

Currently searching for a new urologic surgeon, as my first almost killed me.

Regular Member

Date Joined Dec 2010
Total Posts : 35
   Posted 1/20/2011 7:41 PM (GMT -6)   
Thanks all for the support, information, and perspective everyone. I agree I want to catch any cancer early. I also agree survival to be a parent and husband is my main job. My supportive wife, who obviously has a big stake in the potential side effects of surgery, is ready to take the thing out without a diagnosis and be done with it. She says we'll deal with the side effects if and when they come.

I did have two FreePSA tests. The first one (two years ago) was .24. The one in Dec 2010 was .21. So that's encouraging but doesn't rule anything out, especially since the total PSA on that last one was much lower than a standard PSA test done on the same blood sample. If the total PSA was an underestimate then the Free ratio would have been an overestimate.

I did have the biopsy today.

Bottom line:
The first anesthetic shot was unpleasant but not too bad. After that the whole thing was more annoying than anything. Even the clicking sound wasn't bad.

The doc (Dr. Wei with U of M) was very gentle and communicative throughout. He did 12 cores, 6 on a side. He said he didn't see anything on the ultrasound, which I know doesn't rule out PC but at least it suggests there isn't anything big and ugly going on in there. He will call personally in about a week and then mail me his written report along with the pathology report. He struck me as very experienced yet patient with what must have been his 900th nervous patient.

The longer story:
This office is a part of the University of Michigan Med School which is doing a study on a genetic marker for PC so I started out talking to a researcher, signing consent forms to be a part of the study, and giving a blood sample. If that will make this process easier for my sons then I am happy to help.

My doc gave me a Valium to take before the procedure but I don't think it helped much. I just felt a little drugged. Overall the general anesthesia option would have been a waste for me. I'm glad I didn't go through that extra complication.

By far the worst part of the experience was preparing for the urine sample. The written instructions said I would have to give a sample before and after. So I showed up very well hydrated. Then I waited, legs crossed. Then the research guy came in and talked for a while. I was squirming like one of my kids. As I gave the blood sample my eyeballs were starting to turn yellow. They finally told me I wouldn't give a sample 'till after the procedure, and I said that was going to be a very damp procedure, so they said I could go let a little off the top. A few minutes later another nurse shows up with a sample bottle. She said to give a sample now but save some for later. The story goes on, but suffice to say when I drew up my knees on the table I knew I wasn't going to make it. Fortunately that nurse said I was done giving samples and was patient enough to let me get back up. BIG relief.

The worst of the pain was later in the day when the anesthetic wore off. That's pretty much gone now. And my stream is disappointingly clear. I was looking for some interesting colors!

I'll post an update when I get my results after this longest week of my life!

Regular Member

Date Joined Dec 2009
Total Posts : 130
   Posted 1/20/2011 8:04 PM (GMT -6)   
I never heard of the tinkle sample before or after a biopsy. I've had 2.

And count your blessings about the psychedelic pee.
Age: 55- good health. Exercise regularly.
DRE 11/08- no lumps, just enlarged prostate
1st PSA, total- 11/08= 6.1
2nd PSA, total- 8/09= 6.6
Needle Biopsy 11/09- 12 samples. 11 OK. Right Lateral Mid- Adenocarcinoma Gleason score 3+3=6 9 involving 5% of specimen.
PSA rising from 7.0 to 8.0 thru 2010.
2nd biopsy- 2 positive cores, one a 3+3=6, 3% and the other a 3+4=7, 20%
Treatment needed.
Feb. 2011

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 1/20/2011 9:02 PM (GMT -6)   
There is already one approved urine sample test for detecting prostate cancer. Genetically based, it's much more sensitive than a PSA test..Both Abbott labs and Quest labs are licensed to do this test but so far they have not marketed it..So it's not surprising other companies are developing their own genetically based tests...

Data, you can see from my signature that this is a very imperfect science.. No two cases are the same..The first few threads on this board list all kinds of helpful things, including books. Doctors Walsh and Chodac are a good place to start...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Regular Member

Date Joined May 2010
Total Posts : 264
   Posted 1/20/2011 11:04 PM (GMT -6)   
And my (urine) stream is disappointingly clear. I was looking for some interesting colors!

The first time you ejaculate, your wish for interesting colors may come true.

Seriously, glad your biopsy went smoothly.


Canadian Guy
New Member

Date Joined Dec 2010
Total Posts : 11
   Posted 1/21/2011 4:20 AM (GMT -6)   
This past Tuesday I had my second biopsy in 4 months and am waiting the results . The first biopsy showed positive with 1 core as healthy as I thought I was it was a shock. I feel there is not much or nothing I can do to change this so what ever will be will be .

Veteran Member

Date Joined Jan 2006
Total Posts : 650
   Posted 1/21/2011 6:01 AM (GMT -6)   
Sorry to hear that you are starting this PC anxiety so young. I hope you have a good result. At least the bioposy was not too bad for you.
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent @ 12 months
ED, pre-op severe, post op total
10/10 Dr Boone, Methodist recomended AUS
AUS/ IPP performed 1/11/11 Methodist Houston
post op psa's 0.04,<0.1,<0.1,<0.01@12 mo.

Regular Member

Date Joined Dec 2010
Total Posts : 119
   Posted 1/21/2011 7:48 AM (GMT -6)   
Hey Moredata, welcome to this forum.  I am new here also.
I can't tell you that you don't have cancer, but can tell you my journey and I do not have cancer.
My PSA jumped 2 points 3 years ago.  Then has gone up 1 point every year.  Had the 12 sample biopsy nothing.  Had 30 day anitiobic twice to make sure I did not have an infection and each time PSA would come down half a point, but last round of antibiotic, PSA did not change.  Just went thru the 40 plus sample biopsy with nothing.  Go back to see Dr. in 6 months. 
Dr. said that some mens PSA will do like mine.
Good luck to you and keep us informed.

Regular Member

Date Joined Dec 2010
Total Posts : 172
   Posted 1/21/2011 8:21 AM (GMT -6)   
Was hard for me to hear what the Dr.s had to say as well I was 42 with first slightly elevated PSA we waited a year was still slightly high so off to Uro still slightly high so the biopsy done..I was gratefull actually we found the cancer on first biopsy so i didnt have to just keep repeating that awful experience. I also would ask if you have had free psa checked but kinda late to ask now seeing as you go today for biopsy.

Keep us informed, and best of luck!
age 44 when diagnosed 45 now
RRP 9-28-10
gleason 3+3=6
pathology report all clear
11-1-10 PSA 0.02
3 month PSA 0.00
bladder control 3 weeks post cath. removal!
Osbon pump works great!
some noctural erections stated 12-01-10
5mg Cialis daily 1-3-11 able to get short semi erections(60-75%) with effort daily

Veteran Member

Date Joined May 2009
Total Posts : 725
   Posted 1/21/2011 9:39 AM (GMT -6)   
Re: PSA bouncing up and down. Mine bounced up and down between 2.9 and 4.1, and my urologist told me it probably wasnt PC because if it was, the PSA usually has a steady rise. When it went over 5 I had a biopsy and the rest is history. I assume I had an infection as well as PC, thus the bouncing.
Age: 66
Pre-surgery PSA: 7 tests over 2 years bounced around from 2.6 to 5.6
Biopsy 8 of 12 positive, Gleason 3+4, T2a
DaVinci August 2009, pathology Gleason 4+3, neg margins, T2c
Post-surgery PSA one year of zeros.
Continent right away.
Viagra and other pills only gave me headache
Trimix working great!

Regular Member

Date Joined Dec 2010
Total Posts : 35
   Posted 1/21/2011 10:09 AM (GMT -6)   
Thanks for the stories good and not as good. I figure the best result would be a negative biopsy followed by a PSA decrease that stays down. That seems like a longshot, though. My wife and I agree the next best thing would be a positive core or two with a low Gleason. Then we could get the thing out and move on with our lives. I agree a negative biopsy with a PSA that continues to rise or bounce would be worse than a positive biopsy. That would guarantee more biopsies and leave the possibility the next PSA would be a 20+ and it has spread.

Still hoping for a negative biopsy, but until those PSAs go down and stay down I'm going to feel there's something in there.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4171
   Posted 1/21/2011 11:37 AM (GMT -6)   
You do not have to take that route. It was the route I took for 10 years with 12 negative biopsies and increasing PSA because most doctors have no idea how to distinguish a rising psa is due to prostate cancer or due to other factors.
A PCA3 urine test can give more information.
The best is a color doppler ultrasound and the next best is an MRIS. These can give a very good idea if you have PC and it's extent.
You could also do a 3D mapping biopsy.
All of these options are much better than continuing with biopsies and getting no definative answers. No one should have to undergo more than 2 negative biopsies without getting some answers and piece of mind.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 1/21/2011 11:42 AM (GMT -6)   
"Four Gene Signature Urine Test".. It exists. It spots PC with 97% accuracy. Invented by Health Discovery Corp. And licensed to Abbott Labs and Quest labs..

We need to make some noise and get this test on the market...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Veteran Member

Date Joined Dec 2010
Total Posts : 657
   Posted 1/22/2011 8:55 AM (GMT -6)   
I had the 3D mapping biopsy that John T mentions. As explained to me, it gives a much more comprehensive  result as the entire gland is sampled, and not just the fraction that is accessible to the needle biopsy. And since you are 'out' there is no pain nor humiliation. Also, very few side effects except for bruising in the perineum where the needles were placed, and the gosh awful color of ejaculate which seems to last much longer than one would think it would. When it is all said and done, however, it gives your doc a pretty good idea of what you are or are not up against. Good luck to you.
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